High maternal cholesterol in pregnancy can bring in heart attacks in young adult offspring, according to a new study published in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).
Though a small study held in less than 500 people, the researchers point out that more studies would only help in verifying their findings. Author Dr Francesco Cacciatore (University of Naples Federico II, Italy) said that it is not routinely measured during pregnancy in most countries so there are few studies on its association with the health of offspring.
The study was held in patients admitted to hospital between 1991 and 2019. Of the patients, 89 were admitted with a heart attack and 221 controls were hospitalised for other reasons. For all 310 participants, data were obtained on the mother’s cholesterol during the first and second trimester of pregnancy with that individual.
The average age of the 89 heart attack patients was 47 years and 84% were men. Patients were classified as having a severe or non-severe heart attack. Maternal cholesterol during pregnancy was significantly correlated with each measure of heart attack severity.
The researchers analysed the association between maternal cholesterol during pregnancy and heart attack severity after adjusting for age, sex, body mass index (BMI), number of cardiovascular risk factors (obesity, smoking, high blood pressure, family history of heart disease or high cholesterol, diabetes, prior angina), measured after hospitalisation for the heart attack.
Maternal cholesterol during pregnancy predicted heart attack severity independently of age, sex, BMI, number of risk factors, and serum cholesterol after hospitalisation, with an odds ratio of 1.382 (95% confidence interval 1.046–1.825; p=0.023).
In a second analysis including all 310 patients, the researchers examined the association between maternal cholesterol during pregnancy and atherosclerosis in adult offspring. Because no measurements of atherosclerosis were available for most controls, two surrogate measures were used. These were: 1) number of cardiovascular risk factors; and 2) number of cardiovascular risk factors plus clinical manifestations such as heart attack or stroke.
Pregnant mothers’ cholesterol level was significantly correlated with both measures of atherosclerosis risk, even after adjusting for age, sex and cardiovascular risk factors.
Cacciatore pointed out that the study suggested that a mother’s cholesterol level during pregnancy affects the developmental programming of offspring and heart attack severity in adulthood. However, the study does not establish causality, nor does it allow us to estimate how much maternal cholesterol may contribute to heart attack severity, the author added,